28
International Journal of Food Science and Technology 2021, 56, 28–38
Review
Importance of not skipping breakfast: a review
Rekha Rani,1*
Chetan N. Dharaiya2 & Bhopal Singh3
1 Department of Dairy Technology, Warner College of Dairy Technology, Sam Higginbottom University of Agriculture, Technology and
Sciences, Prayagraj, Uttar Pradesh, 211007, India
2 Department of Dairy Technology, SMC College of Dairy Science, Anand Agriculture University, Anand Gujarat, 388110, India
3 Department of Dairy Technology, Faculty of sciences, DayalBag Educational Institute (Deemed University), Dayalbagh, Agra
UttarPradesh, 282005, India
(Received 18 May 2020; Accepted in revised form 21 July 2020)
Summary
Breakfast is most important meal of the day and usually taken after night fast or after a long gap. Various health surveys and cross-sectional studies reported morning meal positive effect on memory recall,
children performance, mood, work performance, cognitive function, women health like irregular mensuration and reduction in obesity and effect on body mass index. Still people skip breakfast throughout the
world due to several reasons like lack of time, family environment, single-parent family, not feeling hunger in morning or having several misconceptions like thinking of being obese. Skipping morning meal has
an adverse effect on health. This review focuses on awareness of breakfast and its positive impact on
health as the breakfast skipping trend is increasing around the world and also drawing the attention of
researchers to develop convenient, nutritious breakfast options and awareness programmes for significance of breakfast.
Keywords
Breakfast, breakfast meal pattern, breakfast surveys, effect on health, skipping breakfast.
Introduction
Regular intake of breakfast is one of the key indicators of a healthy way of living (Rampersaud et al.,
2005). Breakfast is one of the significant meal for the
human-beings, and good quality breakfast is indispensable for growing people such as children and adolescents, to uphold appropriate fitness. A person without
breakfast will not have enough energy to start a morning task because it is the first meal taken after dinner
with a long gap. A healthy breakfast should include
three major food groups such as grains, milk and
fruits. As per the United States Department of Agriculture (USDA) Food & Nutrition Service (2013), it
should deliver an adequate amount of protein, fibre,
minerals, vitamins and other micronutrients with nominal sugar and fat particularly from processed food
groups (National Institute of Nutrition, 2011). Food
consumption and hunger are regulated by the
hypothalamus, where nucleus arcuatus (ARC) regulate
all processes related to energy balance by interaction
of peripheral hormonal and metabolic signals. Ghrelin
is a peptide produced in stomach, which communicates
modifications in food intake to the central nervous system as hunger-provoking hormone (Otto et al., 2005).
The influence of ghrelin is linked to the antagonism of
the inhibitory effect of leptin on hypothalamic neuropeptide Y (NPY) production (Nakazato et al., 2001;
Shintani et al., 2001; Seoane et al., 2004). Breakfast
consumption is linked with an array of benefits, comprising superior mental performance in adults and
teenagers (Smith & Rees, 2000; O’Sullivan et al.,
2009); enhanced nourishment (Barton et al., 2005; de
la Hunty & Ashwell, 2007); successful reduction in
weight (Lightowler & Henry, 2009) and noticeable
hunger satisfaction, control of total calorie consumption in a day and healthy routine (Cho et al., 2003; de
la Hunty & Ashwell, 2007; Foster-Schubert et al.,
2008; O’Sullivan et al., 2009; Clegg & Shafat, 2010).
As per Baltar et al. (2018), for breakfast consumption,
time is not the single consideration factor, a minimum
50 Kcal energy intake also required during this time;
however, the general definition of breakfast is any consumption of meal after long gap of eating. Drewnowski et al. (2018) also defined for breakfast skippers
as not eaten breakfast or consuming <50 kcal. Family
structure is also one of the factors for consumption
*Correspondent: E-mail: verma.rekha@gmail.com
doi:10.1111/ijfs.14742
© 2020 Institute of Food Science and Technology
Health benefits of breakfast: A review R. Rani et al.
and skipping of breakfast (Levin et al., 2012). Children
staying with ‘both parent’s’ families were consuming
more breakfast than from single-parent families, and
mostly among those staying with their father. In recent
times, the ratio of adults living in non-traditional family categories has increased and it has a direct impact
on adolescent breakfast consumption by changing the
family unit.
The frequency of missing breakfast was 33.1% in
Brazilian adult study (Baltar et al., 2018), the USA
found 23% higher values for adults (Song et al., 2005),
17.3% (Siega-Riz et al., 2000) and 20% (Kant et al.,
2008), Republic of Korea 17.2% (Yoo et al., 2014)
and Japan 16.6% (Lee et al., 2016). However, Taiwan
survey reported ~ 8.0% off morning meal skippers (defined as those who eat breakfast on weekly basis, some
of them never had breakfast or others not so often ate
breakfast (Huang et al., 2010).
In developing countries, decreasing trends were
observed for milk consumption by adolescents as well
as children and the probable thought linked with the
decreasing tendency in cereal-based breakfast consumption (Bowman, 2002; Lioret et al., 2010). KeskiRahkonen et al. (2003) stated that avoiding breakfast
is related with an increased possibility of having a
smoker or consumer of alcohol, doing less exercise or
having increased body mass index (BMI). The decline
in breakfast consumption on the basis of gender bias
also studied and found that girls skip morning meal
more often than boys (Keski-Rahkonen et al., 2003;
Barr et al., 2013). An age-related decrease in breakfast
intake was also observed and found that generally
older adolescents skip breakfast more (Gibson &
Gunn, 2011). Reasons related to this were lack of
time, loss of hunger in the morning, fatigue or drowsiness or individual habits (Raaijmakers et al., 2010).
People who wish to lose weight and dieting are also
one of the main cause of not eating morning meal
(Shaw, 1998; Reddan et al., 2002). Some reports
revealed that the effects of breakfast practices on
energy intake and many reports stated that skipping
breakfast causes a compensatory rise in energy intake
in next day (Astbury et al., 2011). Betts et al. (2014)
also described that regular breakfast consumption was
related with the rise in energy spending during the
morning of breakfast. Gibney et al. (2018) compiled
various breakfast research programmes of different
countries and nutrients intake by breakfast consumers
and skippers. The aim of this review is to discuss on
the importance of not skipping breakfast and positive
effects on health and creating awareness among people, factors of avoiding morning meal and the negative
health effects due to skipping, misbelief towards breakfast consumption, several reasons for skipping breakfast, and among these, family environment is one of
the factor for breakfast intake and skipping.
© 2020 Institute of Food Science and Technology
Cereal-based breakfast
Starting the day with cereals influenced healthy food
choices throughout the whole day. Eating cereals in
breakfast, that is the first meal of the day in the morning was linked with increased intake of carbohydrates
and fibre and reduced intake of fats during the day
(Cho et al., 2003; Kafatos et al., 2005). Certainly, better agility was related to cereal-based breakfast. Eating
of cereals was also related to increased intake of
almost all micronutrients which in turn result in
improved quality of breakfast (van den Boom et al.,
2006). Isaksson et al. (2008) stated that those who ate
whole-grain rye porridge in breakfast had extended
satiety till 8 h. Table 1 gives a glimpse of popular
breakfast used in different states of India and clearly
explains the traditional culture of different states of
India breakfast pattern consists of cereals and grains.
As cereal-based breakfast is superior to other items
like high fat, fried foods and high-calorie items (cold
drinks, full-fat ice cream, etc.).
Breakfast meal pattern
A good breakfast should contain portions from different food groups such as milk, fruits or vegetables and
cereals. Generally, a breakfast meal should contain
one cup of milk, half cup of fruit and/or vegetable
juice along with a portion of cereal which may consist
of either a slice of bread or a serving of muffin/biscuit/
roll or a three-quarter cup of cold dry cereal or a half
cup of hot cooked cereal/pasta/noodles/grains etc. The
pieces of bread should be prepared from whole-grain
or enriched flour while the cereals should also be
whole-grain or fortified (USDA, 2019).
As per the Schools meal patterns suggested by
USDA (2017), schools should provide one cup of fruit
in a day and five cups fruits in a week. Minimum two
cups of starchy vegetables should be served in a week
from the under-consumed subgroups (dark green, red/
orange, legumes) and ‘other vegetables’ subgroups,
during that same week. All grains should be wholegrain-rich. Schools may replace one ounce-equivalent
(oz. eq.) of meat/meat alternate for one oz. eq. of
grains after the minimum daily grains requirement is
met. Calorie content should be 350–500 Kcal up to
fifth-grade students, 400–550 Kcal for 6–8th grade students and 450–600 Kcal for 9–12th grade students.
Saturated fat should provide <10% of total energy,
and trans-fat should be <0.5 g per meal. Sodium content should be <540, 600 and 640 mg for up to 5th
grade, 6–8th grade and 9–12th grade students, respectively. All liquid milk should be either skim milk or
low fat (≤1% fat). Milk may be plain or flavoured.
Table 2 comprises different breakfast patterns studied
in different countries.
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30
Health benefits of breakfast: A review R. Rani et al.
Table 1 Popular breakfast in different states of India
States
Popular varieties
Ingredients
References
Uttar Pradesh
Aloo Puri (Potato curry and oil fried small chapaties)
Vani et al. (2013)
Andhra Pradesh
Pesarattu Upma (Whole green lentil Dosa and stuffed with
some Upma)
Sattu Ka Parathe (toasted gram flour stuffed Indian bread)
Khaman Dhokla (Bengal gram fermented food), Khakhra
(crispy type of roti)
Sabudana Khichdi (Sago spicy mix), poha (Rice flakes), Pav
bhaji (Mixed vegetable along with bread)
Poha and Jalebi (Traditional Indian sweet made up of
refined flour)
Neer Dosa (thin, fluffy dosa made using rice batter)
Cereals (Wheat, Barley) and
vegetables
Cereals and pulses
Cereals and pulses
Pulses (gram lentil or gram
flour, Bajra) and cereals
sago seeds, rice, Cereals
(Barley)
Cereals (Sorghum, chickpea,
flattened rice
Cereals (Finger millet) and
pulses
Buckwheat pancake, rice
Manoharlal et al. (2020)
Roy et al. (2009), Giridhar (2019)
Bihar
Gujarat.
Maharashtra.
Madhya Pradesh
Karnataka
Arunachal
Pradesh
Jharkhand
Kerala
West Bengal
Odisha
Punjab
Rajasthan
Tamil Nadu
Sikkim
Goa
Khura (made roti using kuttu ka atta)
Dhuska ( fermented rice lentil product prepared by deep
fried and salty)
Puttu (Steamed rice cake), idli, dosa (Fermented rice
products)
Cholar Dal (gram lentil)
Chura Bhaja (roasted or fried flattened rice flakes and
potao chips)
Gobi Paratha, Aloo Paratha and Paneer Paratha, Stuffed
paratha (dough stuffed with potato/Cauliflower/paneer
spiced mixture, rolled and cooked in hot tawa with ghee/
oil)
Pyaz kachori (fried pastry filled with a spicy onion filling)
and dal kachori (round compressed ball prepared using
refined flour and filled with mixture of moong and urad
dal, spices stuffing and oil fried)
Idli (steamed fermented product made using rice, rava),
dosa, vada (rice batter with a hole in the middle and fried)
Momos (Wheat flour with meat or vegetable and steamed
dumpling
Rice Bhakri (Round roti prepared using wheat, sorghum
and coarser than wheat chapatti)
Powers et al. (2016) reported that consumption of
cereals along with milk increases micronutrients like
vitamin B, folate and Iron. This may be due to cereal
may have evacuated fat-rich foods from the diet. Similar findings by Deshmukh-Taskar et al. (2010) stated
that if children and adolescents consumed readily to
eat breakfast cereals (RTEC) compared with non-consumers had a lower intake of fat and a higher intake
of carbohydrate in their diet. A study with teenagers
in New Zealand found that the person who skip
breakfast had a greater frequency of snacking (Utter
et al., 2007). It is possible that the cereal and milk
involvement in breakfast had direct impact on reducing the consumption of fat-rich snacks.
People who consumed cereal-based breakfast had
lower body mass index (BMI) than non-consumers
regardless the grains were whole or refined (Bazzano
et al., 2005). Smith et al. (1999) reported that
International Journal of Food Science and Technology 2021
Kannan (2011)
Lahari & Kumar (2019)
Pagote & Rao (2012)
Tamang (2020)
Pandey et al. (2017)
Cereals, rice
Tamang (2020)
rice or buckwheat flour and
coconut
Cereal s and pulses
Deep fried flattened rice
Jacob & Pushpanath (2005),
Tamang (2020)
Joshi & Shinde, (2009), Saha (2014)
Mohanty & Sadual (2019)
Cereals (Wheat) and
vegetable
Vani et al. (2013), Bhosale et al.
(2019)
Cereals (Wheat, barley,
Bajra) and pulses
Agrawal & Sengupta (2014)
Cereals (Rice, Gram) and
pulses
Cereals and pulses
Koh & Singh (2009), Shyam &
Acharya (2019)
Tamang & Thapa (2014), Pandey
et al. (2017)
Badgujar et al. (2017)
Rice and other cereals
participants who had taken cereal-based breakfast
showed a more positive attitude while starting of test
session, displayed better performance on a three-dimensional memory task and were more composed
after completion of the examination compared to the
participants who did not take breakfast.
Breakfast and health
Effect on memory
Better remembrance was related to improved glucose
tolerance and the intake of food with a lower glycaemic index (Nabb & Benton, 2006), demonstrating
that brain performance, particularly memory-related
aspects, may be improved by increase in glucose level
amount (Benton & Sargent, 1992). It has also been
reported that memory is affected negatively by
© 2020 Institute of Food Science and Technology
Health benefits of breakfast: A review R. Rani et al.
Table 2 Survey on breakfast pattern in different countries
Study parameter
Breakfast Patterns
References
371 Korean adults (Three breakfast
pattern)
A nationally representative survey
in Korea (Two breakfast Pattern)
‘Rice, vegetables and kimchi (fermented cabbage, typical of Korean cuisine)’,
‘Potatoes, fruits and nuts’ and ‘Eggs, bread and processed meat’
‘Traditional Korean pattern’ (composed by vegetables, seasonings and condiments,
sugar, salt, fish, grains, potatoes and kimchi)
‘Dairy-cereal pattern’, (containing dairy items, cereals, breads, jellies and fruits)
Brazilian macro-region: (Brazilian Northern) Meats, making with corn, eggs, milkbased items, tubers/roots/potatoes, savoury snacks/crackers, fruit juices/fruit drinks/
soy-based
South eastern Brazilian region – milk, Coffee, tea, cheese, bread and cold cut meats
Sweet baked goods (i.e. cinnamon and danish, buns), ice cream, cakes, cookies, c
and desserts, nuts, sweets, jam and sugar, popcorn, potato crisps, cheese doodles
and soft drinks
A distinctive morning meal contained milk with cocoa powder/soluble chocolate and
sugar, a choice of either breakfast cereals around 34%, biscuits ~ 40%, bread (15%)
or sponge, buns, croissants, etc. (10%). Among them 10% of the group usually took
orange juice at morning time and ~ 5% different type of fruit or fruit salad
Four breakfast patterns were identified: Sweets breakfast ~ 40%, traditional French
morning meal ~ 27%, ready-to-eat cereal with milk ~ 18% and dairy and juice at
morning time (10%)
Found six dietary patterns: cereal and milk ~ 6%, milk and sweetened breads ~ 38%,
sweetened beverages ~ 10%, tortillas and beans ~ 12%, sandwiches and
quesadillas ~ 9%, eggs ~ 8%, breakfast skippers (17%)
Cereal, toast, Eggs, fruit, fruit juices, tea, coffee and soft drinks
Min et al. (2012)
Brazilian breakfast pattern (Two
patterns)
Adolescents food choices at
breakfast, Goteborg, Sweden
Breakfast consumption in Spanish
children and young people (3534
people aged 2–24 years),
Barcelona, Spain
France (2016): A study of 529
children aged 9–11 years in the
city of Rennes
Mexican National Food
Consumption Survey (3760
children), Mexico
United States: The 1994–1996
Continuing Survey of about
23 700 people among which
15 641 adults (aged 18–65 year),
Survey from Chile among young
(19–29 years), Chileans, Santiago,
Chile
Nationally representative sample
surveyed in the 1995 National
Nutrition Survey of 13 858
Australians, Australia
Breakfast in the United States
Four different breakfast patterns: ‘Dairy and cereals’, ‘healthy’, ‘traditional salty’ and
‘traditional sweet’.
Breakfast comprises of fruits nearly 54%, cereals (40.0%) and lower intake of dairybased items (23.0%)
Milk, cereals and bread were the most popular breakfast and < 10% of Australians
ate a cooked breakfast
Food consumed at morning time by US children and adults, the usually eaten foods
were baked goods, sweets, whole-grain RTEC and milk, juice and whole fruit
skipping breakfast (Benton & Parker, 1998; Smith
et al., 1999; Korol, 2002). Eating of breakfast is linked
with improved spatial memory (Benton & Sargent,
1992), free recollection and late recognition memory
(Smith et al., 1994), but had very less impact on tasks
related to attention. Benton et al. (2001) found that
intake of breakfast was related to improved motivation. In their study, they did a survey on 150 young
female adults both fasted and consumed breakfasts of
10 or 50 g corn flakes. They found that those who ate
breakfast, and/or a snack, were feeling fuller. They
reported that those who had consumed breakfast, as
compared to fasting, spend longer trying to recall the
words. It was interpreted that consumption of breakfast was related with better motivation. Others also
© 2020 Institute of Food Science and Technology
Yoo et al. (2014)
Baltar et al.
(2018)
Sjoberg et al.
(2003)
Aranceta et al.
(2001)
Lepicard et al.
(2017), Gibney
et al. (2018)
Afeiche et al.
(2017)
Siega-Riz et al.
(2000)
Ministry of Health
of Chille (2010–
2011), DıazTorrente &
QuintilianoScarpelli (2020)
Williams (2002),
Gibney et al.
(2018)
Drewnowski et al.
(2018), Gibney
et al. (2018)
reported that better glucose tolerance was linked with
better memory.
Effect on obesity
Breakfast consumption has numerous positive impacts
among youth including improved dietary competence,
reduced risk of obesity and improvement in mental ability (Pearson et al., 2009). As per Swinburn et al. (2004)
obesity (defined as body mass index (BMI) >30 kg m 2,
daily consumption of breakfast is linked with diets of
better nutritional quality and better self-reported health
ratings in adults (Nicklas et al., 1998; Williams, 2005)
and also linked with a reduced risk of obesity among
teenagers (Szajewska & Ruszczynski, 2010). Americans
International Journal of Food Science and Technology 2021
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Health benefits of breakfast: A review R. Rani et al.
who avoided breakfast or consumed a fat-rich, low-fibre
breakfast showed higher BMI compared to those who
consumed whole-grain foods after a long gap (Cho
et al., 2003). By regular eating of breakfast, a decrease
in BMI of adolescent girls was observed (Albertson
et al., 2007). In Canada, a cross-sectional study (population-based and nationally representative) was conducted
by taking >18 years women (non-pregnant and non-lactating) and data were collected and observed that BMI
was lower among those consumed ready-to-eat cereal
(RTEC)-breakfast than other types of morning meal
eaters (Barr et al., 2016). Women who consumed RTEC
in breakfast were less obese (BMI 25 kg m 2) as compared to non-consumers. RTEC breakfast consumption
was interrelated with desired macronutrient availability
for reducing obesity and predicted weight status for
females but not for males. Still, there is no relationship
between total and RTEC breakfast consumption on
weight gain and health-related behaviours (Song et al.,
2005). The glycaemic index of cereal-based breakfast is
low which results in the slow release of glucose in the
bloodstream. An inverse relationship between the size of
breakfast and BMI of male respondents was noticed but
the same was not true for female respondents (Kent &
Worsley, 2010). The BMI of male vegetarian respondents was less than that of non-vegetarians. Baltar et al.
(2018) also studied the relationship between breakfast
type and BMI and reported that those ate ready-to-eat
cereal, cooked cereal or slices of bread for breakfast had
lower BMI as compared to breakfast skippers and meat
and eggs eaters. The probable reason for this is with a
good sources of protein and lower level of fat and sugar
and calcium, nutrients currently related with a lower
weight gain (Pasiakos et al., 2015; Pannu et al., 2016).
Effect on cognitive function
Breakfast consumption improves mental performance
in a teenage population as compared to breakfast exclusion (Cooper et al., 2011). Smith et al. (2002) reported
that stress was linked with increased cortisol levels while
regular consumption of cereal-based breakfast was
linked with reduced cortisol levels. Youngsters, who regularly consume breakfast, have reported better exercise
patterns (Keski-Rahkonen et al., 2003) and reasoning or
intellectual performance (Hoyland et al., 2009). Breakfast intake is reported to help in improving mental performance related to memory, performance in
examinations and school attendance (Rampersaud
et al., 2005). A better-quality breakfast can impact positively on youngsters’ mental health (O’sullivan et al.,
2009) and improve whole diet quality (Matthys et al.,
2007; Raaijmakers et al., 2010). Eating a larger breakfast was also concomitant with better presentation on a
test of speaking fluency (Wyon et al., 1997). There were
numerous encouraging impacts on mood after breakfast
International Journal of Food Science and Technology 2021
consumption, viz. increase in self-report awareness.
Breakfast consumption showed no impact on attention
and had a favourable effect on the accuracy of visual
and three-dimensional memory (Widenhorn-M€
uller
et al., 2009). Breakfast, as a determining factor of body
image satisfaction and its eating, had an acute impression on temperament (Lloyd et al., 1996).
Effect on performance of children
Breakfast consumption is believed to be linked with
nutritional fulfilment, optimum body weight and educational performance in teenagers as well as children
(Albertson et al., 2009; Szajewska & Ruszczynski,
2010). Several other reports also stated that breakfast
influenced the output presentation of school-children
(Owens et al., 1997; Wyon et al., 1997). Variations in
physical activity were also observed for those who had
cereal-based breakfast or as an evening meal and
found better performance. If breakfast is provided at
school, it has a positive effect on nutritional status of
the children as well as the effect on children’s weight
and height gain, positive effect on attendance, school
performance like the interaction between programmes
(Cueto, 2001). The relationship between the aptitude
of children towards their school work and the size of
breakfast as well as the need for mid-morning snacks
has been evaluated. The students who has a smaller
breakfast of around 61 kcal significantly worked for
less time than the students who had consumed higher
calorie meals. The contrary effect of a low-calorie
breakfast was overturned by the consumption of a
mid-morning snack (Benton & Jarvis, 2007).
In Sweden, 9- to 12-year-old schoolgoing children
who consumed high-calorie breakfasts and exercised
for a longer time in a morning physical exercise class
and also scored better in speaking fluency test (Wyon
et al., 1997). In 9- to 12-year-old children, breakfast
instead of fasting improved mental performance
(Mahoney et al., 2005). The academic performance of
9- to 12-year-old well-nourished American students
was improved when they consumed breakfast (Pollitt
et al., 1981, 1982). Breakfast considerably enhanced
academic performance and lowered non-attendance
and sluggishness (Benton et al., 2001). In 12- to 13year-old children, consumption of breakfast cereals
reduced the drop in attention and recall which transpired after 3 h when children fasted or had a glucose
drink (Wesnes et al., 2003).
Effect on women health
Fujiwara (2003) observed that young women who generally tend to miss breakfast have a considerably more
occurrence of indications of dysmenorrhoea compared
to young women who regularly consume breakfast,
© 2020 Institute of Food Science and Technology
Health benefits of breakfast: A review R. Rani et al.
which suggests a positive association between skipping
breakfast and menstrual syndromes. Generally, irregular menstruation and dysmenorrhoeal and premenstrual syndrome are measured as representative
menstrual disorders (Deligeoroglou, 2000). Fujiwara &
Nakata (2010) reported the relationship between
breakfast skipping and reproductive function. They
surveyed among 18- to 21-year-old female college-going students. The five surveys on annual basis showed
that the incidence of dysmenorrhoea was considerably
higher among the students who skipped breakfast. The
outcome of the survey suggested that breakfast skipping is linked with menstrual disorders and influences
the physical state of college-going female students who
were undergoing post-adolescent maturation. These
menstrual ailments may impact the quality of life of
young women in the present as well as in the future.
Breakfast habits and family environment
The identification of the effects of regular consumption
of breakfast is essential for developing the interventions intended at encouraging healthier food behaviours among the young population. Habits affecting
health are developed in the family, by the attitudes
and beliefs of parents, behaviours significantly affecting the health behaviours of children (Tinsley, 2003).
Moreover, observations suggest that food preferences
as well as food behaviours developed at a young age
may strengthen with increasing age (Mikkila et al.,
2004). Latest reviews have noticed that parental food
consumption patterns are persistently and positively
linked with both healthy (Pearson et al., 2009) and
unhealthy (Horst et al., 2007) food choices of children
as well as teenagers. Moreover, there is substantial
indication that family background is a key parameter
for influencing the food preferences of children as well
as teenagers (Crockett & Sims, 1995; Story et al.,
2002; Patrick & Nicklas, 2005; Shepherd et al., 2006).
Parents should be inspired to become a positive examples for their child by improving their food behaviours
and the whole family as a single unit should be considered while designing programmes to encourage healthy
breakfast patterns (Pearson et al., 2009). Family structure was certainly linked with the breakfast consumption behaviour of girls above 10 years (Franko et al.,
2008). A German study carried out in children and
teenagers observed that RTEC is preferred over bread
(Alexy et al., 2010). A study conducted in Scotland
from 1994 to 2010 explains alterations in daily breakfast consumption patterns among teenagers. They
observed that the habit of daily breakfast consumption
in teenagers improved between these years but the
teenagers who are aged more than 14.5 years shown a
reduction in breakfast consumption and the increased
tendency was found in teenage girls than boys. The
© 2020 Institute of Food Science and Technology
habit of daily breakfast consumption was more predominant among teenagers who were living with both
the parents, while the lowest prevalence among those
who were living with a single parent. Scotland surveyed in Scottish Health Behaviour in School-aged
Children (HBSC) having an age of girls and boys
between 11 and 15 years by taking data of the year
1994, 1998, 2002, 2006 and 2010 and found that daily
breakfast consumption increased among adolescents
between 1994 and 2010, but variances were observed
based on age and sex. Children above 14.5 years
observed decreases in morning meal intake and girls
were skipping more than boys. Daily breakfast consumption patterns from 1994 to 2010 also influenced
by family structure. The largest section of the people
and frequency of regular breakfast consumption were
greater than before among those living with both parents, and frequency decreased with time among teenagers of single-parent families, and particularly among
those teenagers who were living with their father (levin
et al., 2012). A French study reported that approximately 35% of French children preferred RTEC, while
around 40% preferred bread (Bellisle & RollandCachera, 2007). European multicentre Healthy Lifestyle in Europe by Nutrition in Adolescence
(HELENA) Study with two 24 h dietary recalls of
3137 teenagers were offered food items such as RTEC/
bread, milk/yogurt and fruit and macro- as well as
micro-nutrient intakes at breakfast and observed that
compared to bread breakfasts (39%), RTEC breakfast
(19.5%) and all other breakfasts (41.5%) were linked
with the enhanced nutrient intake (less sucrose as well
as fat; more fibre, more protein and micronutrients
like calcium, magnesium, phosphorus and vitamin B)
at the breakfast among European teenagers, RTEC
consumers exhibited a more favourable nutrient intake
than those who consumed bread or other breakfasts,
except for simple sugars (Michels et al., 2016).
Effects of skipping breakfast
Breakfast is always considered as the most essential
meal of the day; however, the young population is more
likely to skip breakfast (Dwyer et al., 2001) with
approximately 50% of young persons aged between 6
and 11 regularly consume breakfast (Mahoney et al.,
2005). Missing breakfast is very common among many
teenagers in developed countries with the incidence of
skipping breakfast ranging from 3% (Dialektakou &
Vranas, 2008) to 34% (Rampersaud et al., 2005). Furthermore, the frequency of missing breakfast in children
and teenagers is increasing (Siega-Riz et al., 1998). The
various studies conducted by different countries related
to skipping breakfast are given in Table 3.
Consumption of carbohydrate, fibre, calcium, iron,
folic acid, thiamine, riboflavin and vitamins A, C and
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Health benefits of breakfast: A review R. Rani et al.
Table 3 Breakfast skipping and its study parameter
Country
Study parameter
Breakfast skipping
References
United States (2001–2008)
United States (2001–2008)
Mexico (2017)
NHANES data (Children 4057)
NHANES data (adults 10 431)
National Food Consumption Survey
(Children 3760)
Breakfast patterns with children and
young people (aged 2–18 years) = total
2821
Sample size = 34 003 (among that children
7276 and youngsters aged 10–19 years)
Children (aged 4–18 year) = 12 281 and
youngsters above 19 year = 19 913
Children = 1600 teenagers aged between 7
and 18 years
breakfast consumption and nutrient
patterns of children (1686) and teenagers
aged between 11 and 18 years
About 23 700 persons among that 15 641
adults (aged from 18 to 65)
19%
19.7%
17%
O’Neil et al. (2014)
O’Neil et al. (2014)
Afeiche et al. (2017)
9%
Fayet-Moore et al.
(2017)
7%
Pereiraa et al. (2017)
Children = 10% and
adults = 11% skippers
<10%
Barr et al. (2013), Barr
et al. (2014)
Yeoh et al. (2009)
17%
Coulthard et al. (2017)
23.0%
Siega-Riz et al. (2000)
Australia (2017): National Nutrition and
Physical Activity Survey (2011–2012) by
24-h recall method
Brazil (2017): National Dietary Survey
(2008–2009) using two 24-h recalls
Canada (2004): Nationally representative
Canadian Community Health Survey
Korea (2009): National Health and
Nutrition Survey (2001) using 24-h recall
UK (2017): National Diet and Nutrition
Survey Rolling Programme using a 4-day
diary
United States (1994–1996): Survey of food
consumption by people
E was higher in people consuming regular breakfast
than breakfast skippers. Fibre, calcium, iron and folate
intake was about 33%, 37%, 47% and 68% higher
respectively for regular breakfast consumers. The average folate intake for breakfast consumers was 68%
higher than that of the skippers. Farshchi et al. (2005)
reported that skipping breakfast weakens fasting lipids
and postprandial insulin sensitivity and could result in
an increase in weight if the higher energy intake was
persistent.
Approximately 25% of the total Australian adults
and children and several other countries skip breakfast
(Williams, 2002; Keski-Rahkonen et al., 2003). Such
breakfast consumption behaviours may pose a major
public health problem. Moreover, a nutritious breakfast is consumed among just 10% or fewer of adolescents from Belgium (Matthys et al., 2007) and the
Netherlands (Raaijmakers et al., 2010).
In Brazil (2005), a study was conducted to illustrate
the nutritional quality of Brazilian teenagers focusing
on their breakfast habits. In this cross-sectional study,
1133 schoolgoing children (10–14 years old) were
selected, in Niter
oi, Brazil, and information about
breakfast consumption was collected using 24 h dietary recall. From this study, it was found that 16% had
not consumed breakfast on the day of survey while
omitting breakfast was more common among obese
than among non-obese children and among those
students studying in the morning shift than those
studying in the afternoon shift. The average daily
energy, macronutrient, calcium as well as vitamin A
consumptions were considerably more among individuals who regularly consumed breakfast than those who
International Journal of Food Science and Technology 2021
skipped breakfast frequently. They also observed that
breakfast contribution was around 18% to the daily
energy intake. The food profile analysis revealed that
breakfast can be categorised by the type of beverage
consumed in the meal, and five different consumption
patterns were recognised: tea or coffee, milk or milkbased beverages, sweetened beverages, no beverage
consumption and two or more type of beverages. The
study discovered that the dietary breakfast varieties of
Brazilian adolescents were associated with the daily
energy and nutrient intake and the type of beverage
consumed during breakfast. Sugar-based beverages
increased obesity and considered low-quality diet while
milk and milk-based beverages resulted in increased
intake of calcium and vitamin A throughout the day.
Such outcomes can encourage healthy eating behaviour and reduce the consumption of sugar-based
drinks, as they increase obesity and other related diseases across the globe (dos Santos Correa et al., 2016).
The school breakfast program (SBP)
The School Breakfast Program (SBP) is a centrally
assisted meal programme operating in public and nonprofit private schools and residential child care institutions. The SBP started in the year of 1966 as a pilot
project and was made a permanent entitlement programme by Congress in 1975. The Food and Nutrition
Service (FNS) of the United States Department of
Agriculture (USDA) governs the Program at the central level.
Involvement in the SBP has increased steadily over
the years from 0.5 million children in 1970 to 3.6
© 2020 Institute of Food Science and Technology
Health benefits of breakfast: A review R. Rani et al.
million children in 1980; 4.0 million children in 1990;
7.5 million children in 2000; 11.67 million children in
2010; and 14.57 million children in 2016 (USDA,
YEAR). Under this programme, schools having a
higher share of low-income students (a minimum of
40% children receive free or low-price lunch) are considered severe need schools and are eligible for a higher
reimbursement rate. Under this programme, a conventional, cafeteria-based breakfast model, schools may
also consider or an alternative breakfast model. For
example, Breakfast in the Classroom involves serving
the breakfast to children during a morning class, often
while the teacher is taking attendance or giving classroom announcements. Schools operating Grab & Go
Breakfast serve children a breakfast to go, often in a
plastic or paper bag, before school or during a morning break (USDA, 2017; https://www.fns.usda.gov/sb
p/sbp-fact-sheet).
Conclusions
Breakfast has a positive effect on health such as
improved daily routine activity, cognitive function,
memory recall, improve children’s performance and
women’s health. However, skipping breakfast increases
obesity, body mass index and reduces activity and performance during a day. A healthy breakfast should
contain more fibre and protein, less sugar and fat and
rich in vitamin A, vitamin B, minerals (Calcium, iron,
magnesium) for the positive effect on health, cerealbased breakfast increase glycaemic load and glycaemic
index. By knowing significance of breakfast, breakfast
was included in various school programmes. Among
the family environment patterns, the breakfast skipping pattern was found more in single parent-child.
More awareness is required to focus on breakfast consumption and more research required for the development of convenient, ‘grab and go’ breakfast options so
people can consume those have problems like lack of
time in the morning, single parent, nuclear family.
Ready-to-eat cereal-based breakfast (RTEC) can be
considered as a decent breakfast choice due to a
diverse and stable diet.
Acknowledgment
The authors are highly acknowledged to Dr Shalini
Arya for review of this manuscript before submission
Author contribution
Rekha Rani: Conceptualization (equal); Data curation
(equal); Writing-original draft (lead); Writing-review &
editing (equal). Chetan N Dharaiya: Conceptualization
(equal); Writing-review & editing (equal). Bhopal
Singh: Conceptualization (equal); Data curation
© 2020 Institute of Food Science and Technology
(equal); Resources (equal); Writing-review & editing
(equal).
Conflict of interest
There is no conflict of interest among authors.
Ethical approval
Ethics approval was not required for this research.
Peer review
The peer review history for this article is available at
https://publons.com/publon/10.1111/ijfs.14742.
Data availability statement
The breakfast skipping data of different countries covered related to title. The authors are encouraged for
data sharing, mandates for data sharing and peer
review of data.
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